| NPI | 1295850162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD445634) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MD D0068355) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2016-02-11 |