| NPI | 1750347894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD447516) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 124377) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2014-10-15 |