| NPI | 1821136003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TX H2037) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H2037) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2022-10-05 |