NPI | 1689925844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A142293) |
Additional Taxonomies | 208600000X Surgery (Licence: NH 17291) |
208600000X Surgery (Licence: CA A142293) | |
2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0062897) | |
Enumeration Date | 2012-09-27 |
Last Update Date | 2024-03-12 |