| NPI | 1912909532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME0042148) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01059218A) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2010-09-23 |