NPI | 1497703417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WV 17697) |
Additional Taxonomies | 208600000X Surgery (Licence: WV 17697) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2022-09-19 |