| NPI | 1669584819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 89902) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY 41441) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-10-26 |