| NPI | 1942407143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD d91678) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD460083) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-05-25 |