| NPI | 1033539705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 69564) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 298106) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-10-19 |