| NPI | 1063407567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME69865) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL 00009762) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2017-05-03 |