| NPI | 1508152265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: RI MD17198) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 248492) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-08-06 |