NPI | 1851372668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MA 150658) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 150658) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2016-11-15 |