| NPI | 1922033901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: SC 29174) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35093033) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-01-13 |