is a Vascular Surgery in , . practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for is 1386696805. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | , , |
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Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1386696805 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | |
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State | () |
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Provider's Primary Taxonomy Detail
Speciality | Vascular Surgery |
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Taxonomy | 2086S0129X |
Licence No | C39363 |
Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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00C393630 | CA | -- |
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