NPI | 1538424007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME137272) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: RI MD14884) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2021-06-23 |