NPI | 1497173017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME157128) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 88400) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2024-12-20 |