| NPI | 1174513956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 182202) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 182202) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 182202) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2017-09-19 |