NPI | 1932369246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MA 240061) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 240061) |
Enumeration Date | 2008-06-10 |
Last Update Date | 2011-09-01 |