| NPI | 1700863818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101-031974) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101031974) |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101031974) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2010-03-10 |