| NPI | 1881648343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NY 336149) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: PA MD428538) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-05-26 |