| NPI | 1457689283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA 60757701) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A110030) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA A110030) | |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2022-11-07 |