| NPI | 1942220629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD045211L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD045211L) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD045211L) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD045211L) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-12-09 |