| NPI | 1174548713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME0040310) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: FL ME40910) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2017-03-30 |