| NPI | 1598080947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0073310) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD-434653) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2014-09-25 |