| NPI | 1225265861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 284362) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA mt194818) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD444812) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2021-11-17 |