| NPI | 1134166473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301080098) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 321283) |
| 207P00000X Emergency Medicine (Licence: IN 01092546A) | |
| 208600000X Surgery (Licence: MI 4301080098) | |
| 207P00000X Emergency Medicine (Licence: MN 65288) | |
| 207P00000X Emergency Medicine (Licence: MI 4301080098) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-03-12 |