| NPI | 1093733255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 1169211) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 1169211) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-12-09 |