| NPI | 1932329265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A90203) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 089484) |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 089484) | |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2017-01-27 |