| NPI | 1679777585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX N2046) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MS 23432) |
| 208600000X Surgery (Licence: TX N2046) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2023-09-14 |