NPI | 1649271925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD H0062393) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 239940) |
208600000X Surgery (Licence: FL OS14009) | |
208600000X Surgery (Licence: NJ 25MB06746000) | |
Enumeration Date | 2005-08-09 |
Last Update Date | 2024-11-03 |