| NPI | 1881685022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL ME0043578) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME0043578) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2007-07-08 |