| NPI | 1851626329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.098903) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2016-00429) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2021-01-27 |