| NPI | 1447291893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 40583) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: TX M5988) |
| 2086S0129X Surgery Vascular Surgery (Licence: PA MD422860) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-06-20 |