| NPI | 1891724498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX E8996) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX E8996) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX E8996) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2015-04-15 |