| NPI | 1982999199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 266243) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 248341) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2017-04-24 |