| NPI | 1891957627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 94616) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX R2752) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-02-16 |