| NPI | 1841501764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 325797) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09704200) |
| 208600000X Surgery (Licence: KY 51036) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2023-11-06 |