| NPI | 1033320213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: DC MD210002490) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 74386) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD474815) | |
| 208600000X Surgery (Licence: IN 06013379A) | |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2023-02-15 |