| NPI | 1932163169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 37450-20) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD425691) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-10-30 |