| NPI | 1205866654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35079902) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 3609197) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-04-20 |