| NPI | 1932149507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35.070929) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2015-02082) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NC 2015-02082) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-01-25 |