| NPI | 1699790899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A24258) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A24258) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA A24258) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |