NPI | 1184608903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2018031906) |
Additional Taxonomies | 174400000X Specialist (Licence: VA F89770) |
2086S0129X Surgery, Vascular Surgery (Licence: IL 036119888) | |
Enumeration Date | 2005-12-05 |
Last Update Date | 2022-09-14 |