| NPI | 1437165495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NY 230350) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 230350) |
| 2086S0129X Surgery Vascular Surgery (Licence: CT 049882) | |
| 208600000X Surgery (Licence: CT 049882) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-09-02 |