| NPI | 1598733586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: UT 29506-1205) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: PA MD422280) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-05-31 |