| NPI | 1063675908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D70352) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 235152) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2013-01-31 |