| NPI | 1407806797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA C160417) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX L0817) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MD D63527) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-03-11 |