| NPI | 1194988642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX P3290) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY 44238) |
| Enumeration Date | 2008-07-04 |
| Last Update Date | 2025-03-03 |