| NPI | 1578664488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME134014) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301075173) |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101248214) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301075173) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-12-07 |