| NPI | 1629006887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 38009) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 208604) |
| 2086S0129X Surgery, Vascular Surgery (Licence: SC 31241) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.097121) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: ME MD19729) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-08-23 |