NPI | 1730676362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX BP10084099) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301504105) |
Enumeration Date | 2018-04-19 |
Last Update Date | 2024-10-14 |