| NPI | 1770558058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35050519) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35050519) |
| 208600000X Surgery (Licence: OH 35050519) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-09-26 |