NPI | 1679525539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301072188) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301072188) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2022-12-20 |