| NPI | 1063632149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 42604) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX M1356) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2023-09-19 |