| NPI | 1578918520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S9814) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ R75495) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2021-06-02 |