NPI | 1699045211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX R5600) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ R73123) |
2086S0129X Surgery, Vascular Surgery (Licence: TX R5600) | |
Enumeration Date | 2012-01-12 |
Last Update Date | 2024-03-06 |