| NPI | 1881640241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SD 1684) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 26021) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2010-04-27 |