| NPI | 1396238945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A198961) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: TX U0818) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2024-09-27 |