NPI | 1255331278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD044363E) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD044363E) |
2086S0102X Surgery, Surgical Critical Care (Licence: PA MD044363E) | |
2086S0129X Surgery, Vascular Surgery (Licence: ND PT15702) | |
Enumeration Date | 2005-08-01 |
Last Update Date | 2023-10-30 |