NPI | 1053555110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 202K00000X (Licence: AZ 873) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ 006421) |
2086S0129X Surgery, Vascular Surgery (Licence: AZ 006421) | |
Enumeration Date | 2009-04-20 |
Last Update Date | 2022-07-12 |