| NPI | 1013322973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.149554) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.064955) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-10-17 |