| NPI | 1376519488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NM MD2014-0991) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0062101) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX K9455) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2015-04-13 |