| NPI | 1043265382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35062416) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35062416) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35062416) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-07-12 |