| NPI | 1518059427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M-10682) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: ID M-10682) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-06-17 |