| NPI | 1548467939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 002507) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 121012) |
| 208600000X Surgery (Licence: GA 002507) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 121012) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-07-12 |