| NPI | 1992895783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.014427) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 014427) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-11-06 |