| NPI | 1770631475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME154691) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 51214) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-04-22 |