NPI | 1992720601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 27665) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MA 218312) |
2086S0129X Surgery, Vascular Surgery (Licence: PA MD460145) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2024-12-18 |