| NPI | 1295985554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2019008677) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD444137) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 252045) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35126367) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 46827) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2024-01-16 |