| NPI | 1972522282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH 17053) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 80230) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-05-12 |