| NPI | 1336342369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A128680) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN11150) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-07-21 |