NPI | 1760882401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A169661) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10302700) |
208600000X Surgery (Licence: PA MD463921) | |
208600000X Surgery (Licence: NY 287637) | |
Enumeration Date | 2014-08-31 |
Last Update Date | 2020-09-01 |