| NPI | 1861491086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI RI5902) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: RI MD05902) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2010-11-23 |