| NPI | 1295755908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00019056) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: WA MD00019056) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-02-24 |