| NPI | 1689652893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G68221) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN 18775) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-10-30 |