NPI | 1346401312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 236902) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA Fl262317) |
Enumeration Date | 2008-06-22 |
Last Update Date | 2020-03-12 |