| NPI | 1063448991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.123446) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101232576) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2018-05-02 |