| NPI | 1275896508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 323549) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0062437) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-04-18 |