| NPI | 1801004262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.025243) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: LA 025243) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2009-11-18 |