NPI | 1376803106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX R2159) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX 566858) |
Enumeration Date | 2012-05-27 |
Last Update Date | 2020-03-09 |