NPI | 1689831257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME107623) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME107623) |
208600000X Surgery (Licence: PA mt188847) | |
2086S0129X Surgery, Vascular Surgery (Licence: IA MD-44080) | |
Enumeration Date | 2008-05-20 |
Last Update Date | 2024-02-29 |