| NPI | 1164597910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 34005679) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 34005679) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2025-05-13 |