| NPI | 1619043890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 9875) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: AZ AZ 9875) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 9875) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-03-04 |