| NPI | 1093799165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX L3462) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA C128526) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-10-12 |