| NPI | 1982819579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OH 35125624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46328) |
| 207R00000X Internal Medicine (Licence: OH 35125624) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-11-03 |