| NPI | 1659514321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: HI DOS-1255) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q9926) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX Q9926) | |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2021-06-17 |