| NPI | 1801866876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 005292) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX J2871) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2009-08-17 |