| NPI | 1649584251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME105742) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME105742) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2018-08-01 |