| NPI | 1154587459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: AZ 48232) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 35.097864) |
| 2086S0129X Surgery Vascular Surgery (Licence: MI 4301098947) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2017-04-19 |