| NPI | 1639103583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 100462) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: MO 100462) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 100462) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-12-01 |