| NPI | 1760483549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A13459) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A13459) |
| 208600000X Surgery (Licence: VA 0102201488) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: WV 1938) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2024-01-19 |