| NPI | 1487778239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 20344) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA a76552) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2019-02-26 |