| NPI | 1023275526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX P1961) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A79653) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-01-19 |