| NPI | 1992908354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD440422) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT190217) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2015-02-19 |