| NPI | 1528289808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TN 48394) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 096419) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2018-03-29 |