| NPI | 1497920953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX Q3287) |
| Additional Taxonomies | 208600000X Surgery (Licence: ZZ 252282) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2015-07-16 |