| NPI | 1447300389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00020089) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00020089) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2021-04-06 |