| NPI | 1679781546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-02237) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35097669) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-10-03 |