| NPI | 1487666319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NV 14382) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 59904-20) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX 41458) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2023-10-04 |