| NPI | 1518074939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD 29579) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD29579) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-04-07 |