| NPI | 1336149624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA md020061e) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD020061E) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2018-11-06 |