| NPI | 1831345065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX P8751) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 238115) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2014-03-03 |