| NPI | 1730138892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.140498) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.140498) |
| 208600000X Surgery (Licence: MI 4301503585) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301503585) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0069648) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2024-11-08 |