| NPI | 1619389939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 29926) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX S8934) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NM A-2473-21) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2024-01-02 |