| NPI | 1275513715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MD D0064058) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: VA 0101232175) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2017-03-29 |