NPI | 1649432337 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CO 054269) |
Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WI 55469-20) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2021-06-14 |