| NPI | 1891742128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI AK093222) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 223607) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2018-03-17 |