| NPI | 1316145352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 24055) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML20008974) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 56930) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 106982) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-11-27 |