| NPI | 1356343008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35091329) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 33460) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 41850) | |
| 208600000X Surgery (Licence: OH 35091329) | |
| 174400000X Specialist (Licence: KY 41850) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2014-12-10 |