| NPI | 1770762098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX S1997) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN 44223) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 180091) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: AZ 43434) | |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2022-10-11 |