NPI | 1770928780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MN 59457) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 59457) |
Enumeration Date | 2013-05-03 |
Last Update Date | 2018-07-03 |