| NPI | 1518024678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 224833) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 224833-1) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 224833) | |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2021-09-14 |