| NPI | 1083691521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35-048117) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35048117) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2011-11-22 |