NPI | 1932367919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD445620) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD445620) |
Enumeration Date | 2008-05-27 |
Last Update Date | 2020-09-30 |