| NPI | 1760434252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 57626) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD028899e) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-08-16 |