| NPI | 1174594683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD-060731-L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD-060731-L) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-05-15 |