| NPI | 1013232289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME124998) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NY 280720) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2023-10-11 |