| NPI | 1578596938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101253975) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2009020458) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD430518) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-11-16 |