NPI | 1841242013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 35564) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: LA MD.08793R) |
2086S0129X Surgery, Vascular Surgery (Licence: MN 61146) | |
Enumeration Date | 2006-05-16 |
Last Update Date | 2021-04-28 |