| NPI | 1609832997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD033600E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD033600E) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2020-07-13 |