NPI | 1538123534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: LA 1256R) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MS 27948) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2024-06-26 |