| NPI | 1821108564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MT 27813) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX P3786) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-04-15 |