| NPI | 1558396606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH 14159) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 226016) |
| 208600000X Surgery (Licence: MA 229041) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 52620) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD456855) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-11-12 |