NPI | 1518462050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 73094) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A163899) |
Enumeration Date | 2018-03-27 |
Last Update Date | 2023-10-27 |