| NPI | 1598939068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX N3674) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 57.014080) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX N3674) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2022-04-09 |