| NPI | 1629079371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0102204376) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA OS007358L) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2016-02-02 |