| NPI | 1386933000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME128476) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MS 22630) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2022-02-09 |