| NPI | 1558623793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 009102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO3099) |
| 207Q00000X Family Medicine (Licence: AZ 009102) | |
| 208600000X Surgery (Licence: AZ 009102) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA 20A16912) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-08-17 |