NPI | 1003027822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 20033) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 20033) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2018-05-15 |