| NPI | 1821079096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35066676) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35066676) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35066676) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI 4301102239) | |
| 208600000X Surgery (Licence: MI 4301102239) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2013-05-02 |