NPI | 1649432170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO 0054857) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301092469) |
Enumeration Date | 2008-06-26 |
Last Update Date | 2021-06-14 |