NPI | 1023037348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101258172) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 2011-01858) |
208600000X Surgery (Licence: SC 29136) | |
Enumeration Date | 2006-07-18 |
Last Update Date | 2023-02-28 |