| NPI | 1174913917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: IL 036152279) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MI 5101025184) |
| 2086S0129X Surgery Vascular Surgery (Licence: NY 295327) | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2023-01-25 |