| NPI | 1942441340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NC 2012-00317) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 252099) |
| 2086S0129X Surgery Vascular Surgery (Licence: NY 252099) | |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2012-03-07 |