| NPI | 1982752671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME110487) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 89450) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2023-03-14 |