NPI | 1174557037 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 24711) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01046196) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2020-10-27 |