NPI | 1407875032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 63668) |
Additional Taxonomies | 208600000X Surgery (Licence: SC LL25878) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2024-01-25 |