| NPI | 1902849532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 9501660) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 18232) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-10-10 |