| NPI | 1306863865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD440160) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2000157484) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 2000157484) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2017-03-21 |