| NPI | 1053469361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H0814) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX H 0814) |
| 208600000X Surgery (Licence: TX H0814) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2016-10-12 |