| NPI | 1760652911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD440394) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA FI2065058) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2024-07-10 |