| NPI | 1225443393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME150750) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT206680) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036173270) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2025-01-15 |