| NPI | 1043524481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60535104) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ R72267) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2023-05-31 |