| NPI | 1184605347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WA MD60327871) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J8003) |
| 208600000X Surgery (Licence: WA MD60327871) | |
| 208600000X Surgery (Licence: TX J8003) | |
| 2086S0129X Surgery Vascular Surgery (Licence: TX J8003) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2023-12-13 |