| NPI | 1053707703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036160967) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.066426) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2022-07-27 |