| NPI | 1467422857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD037966E) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD037966E) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD037966E) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2019-06-06 |