NPI | 1629145974 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CO 44862) |
Additional Taxonomies | 208600000X Surgery (Licence: CO 44862) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2015-11-04 |