| NPI | 1639412018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S7572) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 293871) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-10-01 |