NPI | 1629206032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA08690700) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: SC 88728) |
2086S0129X Surgery, Vascular Surgery (Licence: MN 71127) | |
208600000X Surgery (Licence: CT 046756) | |
Enumeration Date | 2009-06-24 |
Last Update Date | 2024-10-31 |