| NPI | 1922357243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: DC MD045011) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0087810) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2019-10-01 |