| NPI | 1396994109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 271949) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD18370) |
| 2086S0129X Surgery, Vascular Surgery (Licence: ME MD18370) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MA 260511) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2022-09-14 |