NPI | 1629167176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 166525) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 166525) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2010-11-04 |