| NPI | 1982086682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301505968) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT209243) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-03-24 |