| NPI | 1568564524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH 13519) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 13519) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2015-07-20 |