| NPI | 1710392071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD477818) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 125.064628) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 52325) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2023-04-03 |