| NPI | 1952513202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX P5423) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101016911) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX P5423) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-02-28 |