| NPI | 1184608903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MO 2018031906) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA F89770) |
| 2086S0129X Surgery Vascular Surgery (Licence: IL 036119888) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2022-09-14 |