NPI | 1245229004 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 56897) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ 56897) |
Enumeration Date | 2005-10-14 |
Last Update Date | 2021-06-22 |