| NPI | 1366430316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: DC D0034245) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MB07611900) |
| 208600000X Surgery (Licence: MD H0065639) | |
| 208600000X Surgery (Licence: DC DO034245) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MD H0065639) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2012-07-18 |