NPI | 1538455399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: KY 51366) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT199190) |
2086S0129X Surgery Vascular Surgery (Licence: OH 128605) | |
208600000X Surgery (Licence: PA MD453795) | |
Enumeration Date | 2011-06-21 |
Last Update Date | 2024-01-19 |