| NPI | 1619922291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A68397) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101239726) |
| 208600000X Surgery (Licence: VA 0101239726) | |
| 174400000X Specialist (Licence: VA 0101239726) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2013-06-21 |