| NPI | 1235247735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX G2875) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX G2875) |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2024-04-20 |