| NPI | 1033159850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NE 26130) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35087704) |
| 208600000X Surgery (Licence: NE 26130) | |
| 208600000X Surgery (Licence: IA 39451) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: IA 39451) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-10-04 |