| NPI | 1740338383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD443775) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 34192-020) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NH 20539) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2025-01-29 |