| NPI | 1235365032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME124268) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 240832) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2022-01-04 |