NPI | 1952578262 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A124702) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A124702) |
Enumeration Date | 2008-05-15 |
Last Update Date | 2014-09-16 |