| NPI | 1639249469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 27523) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101232133) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 27523) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2013-08-06 |