NPI | 1043204662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 214744) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 214744) |
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 214744) | |
Enumeration Date | 2005-09-09 |
Last Update Date | 2022-07-21 |