NPI | 1184869448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD154186) |
Additional Taxonomies | 208600000X Surgery (Licence: OR MD154186) |
Enumeration Date | 2008-12-15 |
Last Update Date | 2025-02-11 |