| NPI | 1023066495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 606) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 0606) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-10-01 |