| NPI | 1689676793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35043188) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35043188H) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2012-02-09 |