| NPI | 1003062258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH LT3427) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML 20007737) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2023-06-02 |