| NPI | 1831287242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MS 25429) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD061780L) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-12-08 |