| NPI | 1649488099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME114031) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD431182) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-03-05 |