| NPI | 1770667677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 162428) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 162428) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 162428) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-05-03 |