NPI | 1508887068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 200601485) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD d0062370) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2021-02-17 |