| NPI | 1639141658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60960092) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WA 60960092) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35090482) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: VA 01010S5443) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-12-07 |