| NPI | 1760436430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301090978) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 22039) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-09-07 |