NPI | 1326044330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 068549) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY 24250) |
2086S0129X Surgery, Vascular Surgery (Licence: IN 01066838A) | |
Enumeration Date | 2005-06-23 |
Last Update Date | 2012-12-10 |