| NPI | 1578521662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OH 35.080989) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301080669) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX L3793) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-08-06 |