| NPI | 1689710279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME101072) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: FL ME101072) |
| 2086S0129X Surgery Vascular Surgery (Licence: GA 066920) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-01-24 |