| NPI | 1700888732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR N6929) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AR N6929) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2009-11-18 |