| NPI | 1346357878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NE 24803) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TN MD41290) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD057183L) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-04-21 |