| NPI | 1598799959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OH 35064210M) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35064210M) |
| 208600000X Surgery (Licence: KY 32950) | |
| 2086S0129X Surgery Vascular Surgery (Licence: KY 32950) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-05-26 |