| NPI | 1891978128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WA MD60021352) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: CA A78915) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2015-01-15 |