NPI | 1831114974 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: OR MD27109) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD00042389) |
208600000X Surgery (Licence: CO DR.0061555) | |
2086S0129X Surgery, Vascular Surgery (Licence: TX M3023) | |
Enumeration Date | 2006-07-12 |
Last Update Date | 2018-11-27 |