| NPI | 1548279607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-03-9725-C) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 46279) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OR MD28836) | |
| 208600000X Surgery (Licence: OR MD28836) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2014-09-30 |