| NPI | 1588826804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD171554) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT193480) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-11-30 |