NPI | 1508841966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NC 2021-02828) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WA 60594978) |
2086S0129X Surgery, Vascular Surgery (Licence: MA 237957) | |
2086S0129X Surgery, Vascular Surgery (Licence: MI 4301073233) | |
Enumeration Date | 2005-12-08 |
Last Update Date | 2023-12-01 |