NPI | 1598756595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ND 15311) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WV 22434) |
208600000X Surgery (Licence: NM 20030588) | |
2086S0129X Surgery, Vascular Surgery (Licence: WV 22434) | |
Enumeration Date | 2005-10-31 |
Last Update Date | 2023-04-13 |