| NPI | 1669554440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 129580) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NY 129580) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2019-01-09 |