| NPI | 1144514340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MD D86714) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: PA MD474306) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-08-18 |