| NPI | 1942290721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR-49573) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 219424) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 219424) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-07-28 |