| NPI | 1942414982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX P5352) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR 390200000X) |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX P5352) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2015-04-15 |