| NPI | 1881609527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35075389) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD063158L) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WV 19495) | |
| 208D00000X General Practice (Licence: OH 35075389) | |
| 208D00000X General Practice (Licence: PA MD063158L) | |
| 208D00000X General Practice (Licence: WV 19495) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35075389) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD063158L) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 19495) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2007-07-08 |