| NPI | 1366679623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S9406) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR50080) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60794500) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO DR50080) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2024-06-12 |