| NPI | 1003801333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME100609) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD0578081) |
| 208600000X Surgery (Licence: OH 35-06-2777) | |
| 208600000X Surgery (Licence: FL ME100609) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2016-09-23 |