NPI | 1841336138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: ID MC0957) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA G34124) |
2086S0129X Surgery, Vascular Surgery (Licence: AZ 59047) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2021-07-23 |