| NPI | 1871771808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0068616) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 059229) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2016-04-14 |