NPI | 1396067682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 250719) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 250719) |
Enumeration Date | 2010-02-27 |
Last Update Date | 2023-12-19 |