| NPI | 1124551601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036159691) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.159691) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2022-08-25 |