| NPI | 1467415091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD041172L) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD041172L) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2014-09-30 |