| NPI | 1932390937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME107576) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 223004) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2010-10-13 |