| NPI | 1437268943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TX F0537) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 11435) |
| 174400000X Specialist (Licence: TX F0537) | |
| 174400000X Specialist (Licence: CA C42419) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-03-07 |