| NPI | 1306833322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD027547E) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD027547E) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2011-01-04 |