| NPI | 1992793947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-05-1982-D) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 35-05-1982-D) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OH 35.051982) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2022-07-21 |