| NPI | 1083664254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: KY 40007) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.093617) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-01-19 |