| NPI | 1427011394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WA MD00034494) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MT 49456) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-09-06 |