| NPI | 1508918616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A97247) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME 115350) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2017-01-18 |