| NPI | 1619959673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME159968) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AL 00023846) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-04-23 |