| NPI | 1457435398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX K6159) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX K6159) |
| 2086S0129X Surgery, Vascular Surgery (Licence: AR E-7074) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-10-19 |