| NPI | 1154396034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AK MEDS7917) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036100829) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2017-10-11 |