| NPI | 1487842597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA a104925) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A104925) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2023-01-17 |