| NPI | 1386731248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD040102L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD040102L) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-04-06 |