| NPI | 1508950080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.138221) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD423818) |
| 208600000X Surgery (Licence: MD D0065010) | |
| 208600000X Surgery (Licence: NY 236123) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101257435) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-02-08 |