| NPI | 1497790026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CT 027199) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CT 027199) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2014-01-23 |