| NPI | 1598925067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35123104) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301110976) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2023-11-03 |