| NPI | 1295938611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME123442) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: NY 274587) |
| 202K00000X Phlebology (Licence: PR 18004) | |
| 207R00000X Internal Medicine (Licence: NY 274587) | |
| 207R00000X Internal Medicine (Licence: FL 123442) | |
| 207R00000X Internal Medicine (Licence: OK 29407) | |
| 207R00000X Internal Medicine (Licence: PR 18004) | |
| 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist | |
| 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: 18004) | |
| 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: PR 18004) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-06-08 |