| NPI | 1235368606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME169486) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WV 27485) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2024-09-30 |