| NPI | 1790913945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD440082) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WV 24447) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2022-10-19 |