| NPI | 1134191752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD444690) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA G55336) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60394714) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-08-29 |