NPI | 1821346628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX R3658) |
Additional Taxonomies | 208600000X Surgery (Licence: TX R3658) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2020-07-07 |