NPI | 1891797429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX L1987) |
Additional Taxonomies | 208600000X Surgery (Licence: TX L1987) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2014-01-08 |