| NPI | 1528017068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 058878) |
| Additional Taxonomies | 202K00000X (Licence: GA 058878) |
| 207P00000X Emergency Medicine (Licence: AL 23068) | |
| 207R00000X Internal Medicine (Licence: GA 058878) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2018-03-17 |