NPI | 1245222041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IA MD-26571) |
Additional Taxonomies | 208600000X Surgery (Licence: IA 26571) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2018-05-29 |