| NPI | 1982890786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME143589) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01085444A) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2021-05-20 |