| NPI | 1811936792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NE 22774) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MD D0062067) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-02-25 |