| NPI | 1407077316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD420899) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA BC8571742) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-04-24 |