NPI | 1164606026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 2022-01915) |
Additional Taxonomies | 208600000X Surgery (Licence: NC 2022-01915) |
208600000X Surgery (Licence: LA MD.200997) | |
2086S0129X Surgery, Vascular Surgery (Licence: TX N6165) | |
Enumeration Date | 2007-12-27 |
Last Update Date | 2023-06-20 |