| NPI | 1326192998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MA 59352) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NY 249876) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-02-23 |