| NPI | 1508815762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CT 040506) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 232988) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 232988) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2022-09-26 |