| NPI | 1073693594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 157204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 157204) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 157204) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-03-03 |