| NPI | 1861602690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD449363) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 226548) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 226548) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-11-05 |