| NPI | 1245225549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY NY129075) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY NY129075) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2016-08-18 |