| NPI | 1417936493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101222211) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD30891) |
| 2086S0129X Surgery, Vascular Surgery (Licence: DC MD30891) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-07-26 |