| NPI | 1295902385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX N7567) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25ma08064900) |
| 208600000X Surgery (Licence: TX N7567) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25ma08064900) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA a104216) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2021-06-01 |