| NPI | 1366406589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 64030) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35074786C) |
| 2086S0129X Surgery, Vascular Surgery (Licence: SC 39174) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-03-25 |