| NPI | 1063404986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: IA MD-19793) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: IA 19793) |
| 2086S0129X Surgery Vascular Surgery (Licence: IA 19793) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2018-06-08 |