| NPI | 1275795361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL OS9568) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL OS9568) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 340045) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-02-20 |