NPI | 1073714358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 201525) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CT 044485) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2023-03-07 |