| NPI | 1841251188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID MC0947) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00016876) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OR MD214650) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2023-07-27 |