NPI | 1104834639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NV 13783) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD23440) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2021-03-23 |