| NPI | 1376704619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD451748) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D86916) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-06-26 |