| NPI | 1326485038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH 20710) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OTO15491) |
| 208600000X Surgery (Licence: NH 20710) | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2020-08-26 |