NPI | 1053301150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.023188) |
Additional Taxonomies | 208600000X Surgery (Licence: LA MD.023188) |
Enumeration Date | 2005-10-28 |
Last Update Date | 2023-11-07 |