NPI | 1942407143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD d91678) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD460083) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2022-05-25 |