NPI | 1285958967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60918935) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 66585-20) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2019-08-28 |