| NPI | 1871525998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA G17126) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G17126) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-10-02 |