| NPI | 1013004548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD11222) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OR MD11222) |
| 208600000X Surgery (Licence: OR MD11222) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD11222) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD11222) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OR MD11222) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: OR MD11222) | |
| 208800000X Urology (Licence: OR MD11222) | |
| 2088P0231X (Licence: OR MD11222) | |
| 208C00000X Colon & Rectal Surgery (Licence: OR MD11222) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD11222) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-09 |