| NPI | 1184885873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A113601) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A113601) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1864) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2023-07-19 |