| NPI | 1881668192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 184606) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 184606) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2014-03-19 |