| NPI | 1013918317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OK 30423) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 084224) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 084224) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-06-06 |