| NPI | 1841499191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN 49586) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: PA MD444891) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2018-02-12 |