NPI | 1861785503 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL 140604) |
Additional Taxonomies | 208600000X Surgery (Licence: TX BP10040259) |
Enumeration Date | 2011-05-26 |
Last Update Date | 2020-11-18 |