| NPI | 1518901842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX G2454) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX G2454) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2011-09-20 |