| NPI | 1437470606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 256334) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-244121) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2019-10-28 |