| NPI | 1740245943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NC 2009-00169) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 35070536) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-08-25 |