| NPI | 1578753257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 241134) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME107464) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2022-12-29 |