| NPI | 1285664789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35065279Z) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY 29635) |
| 208600000X Surgery (Licence: OH 35065279Z) | |
| 208600000X Surgery (Licence: KY 29635) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-12-17 |