NPI | 1619905999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID M8695) |
Additional Taxonomies | 208600000X Surgery (Licence: ID M8695) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2020-10-06 |