| NPI | 1710975909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME69886) |
| Additional Taxonomies | 202K00000X (Licence: FL ME69886) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-07-22 |