| NPI | 1255597050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD457996) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101249641) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2024-07-17 |