| NPI | 1598887275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME125876) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD432316) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2022-02-10 |