| NPI | 1194952911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S3284) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 265297) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2023-07-06 |