| NPI | 1598071987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 25107) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT198237) |
| 208600000X Surgery (Licence: PA 1598071987) | |
| 208600000X Surgery (Licence: NJ 25MA09873900) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2022-07-21 |