| NPI | 1639339351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101268808) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.131320) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.131320) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2021-07-31 |