| NPI | 1336364991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 320110) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX N6033) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-02-14 |