| NPI | 1205863842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME108367) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL 27074) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-01-31 |