| NPI | 1760637870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME12422) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: FL 012422) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2011-11-18 |