| NPI | 1508872540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 72621) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 23700) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NE 23700) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60704466) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-01-16 |