NPI | 1154390953 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0023427) |
Additional Taxonomies | 208600000X Surgery (Licence: MD D0023427) |
Enumeration Date | 2006-03-15 |
Last Update Date | 2018-05-23 |