| NPI | 1780831255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO 51312) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A90673) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2013-06-04 |