| NPI | 1366881385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AL 46406) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.135627) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2024-02-01 |