| NPI | 1982681995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IA md-26585) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IA 26585) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2017-01-26 |