| NPI | 1871810440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME135410) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2010-01881) |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2019-01-16 |