NPI | 1235665308 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 333584) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT213385) |
Enumeration Date | 2017-05-10 |
Last Update Date | 2022-11-21 |