| NPI | 1811974652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60003977) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G86126) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA G86126) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G86126) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2021-05-10 |