| NPI | 1972575298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 87845) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD423676) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD423676) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-09-20 |