| NPI | 1548228588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN 40003) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A31869) |
| 208600000X Surgery (Licence: CA 31869) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-01-29 |