| NPI | 1821193277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: RI MD19352) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 208758) |
| 2086S0129X Surgery Vascular Surgery (Licence: MA 208758) | |
| 2086S0129X Surgery Vascular Surgery (Licence: CT 74635) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2023-06-05 |