NPI | 1356310742 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101232663) |
Additional Taxonomies | 174400000X Specialist (Licence: VA 0101232663) |
208600000X Surgery (Licence: VA 0101232663) | |
Enumeration Date | 2006-03-16 |
Last Update Date | 2023-07-18 |