| NPI | 1285997734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 281117) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: RI MD18619) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2024-11-08 |