| NPI | 1851490775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 230078) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 230078) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 49024) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX P8652) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2019-07-30 |