| NPI | 1861628059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SD 8433) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD442070) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2022-08-07 |