| NPI | 1124079249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036139185) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: VA 0101249785) |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 35-072723) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 38823) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2021-04-28 |