| NPI | 1689961716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX Q8436) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 52255) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TN 60280) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2019-10-13 |