| NPI | 1982627071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD052677L) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA BB4287618) |
| 208600000X Surgery (Licence: MD D0059723) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 200901618) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 010125051) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-09-30 |