| NPI | 1881984656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NC 2018-00442) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-00442) |
| 2086S0129X Surgery Vascular Surgery (Licence: OH 35.142463) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2023-11-14 |