| NPI | 1316396161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME150746) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC LL39503) |
| Enumeration Date | 2016-06-11 |
| Last Update Date | 2023-04-12 |