| NPI | 1487677050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD447459) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101233976) |
| 208600000X Surgery (Licence: PA MD447459) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-03-21 |