| NPI | 1659336535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60629001) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 11697) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NH 11697) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2016-05-06 |