| NPI | 1447310362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD043896L) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 41860) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-11-09 |