| NPI | 1881909117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 53445) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MN 104890) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-10-04 |