NPI | 1376778274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 61692) |
Additional Taxonomies | 208600000X Surgery (Licence: MA L-240525) |
2086S0129X Surgery, Vascular Surgery (Licence: MA 261471) | |
Enumeration Date | 2009-05-20 |
Last Update Date | 2020-08-20 |