| NPI | 1649439068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD442412) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 235057-1) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 52356) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 104471) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2020-08-10 |