| NPI | 1538176482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MD D45019) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: MD D45019) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2010-12-08 |