| NPI | 1720206568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: RI MD13705) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP00868) |
| 208600000X Surgery (Licence: RI MD13705) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MA 252777) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-01-29 |