| NPI | 1205091428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D79445) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036117410) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA TMD004761) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2020-08-28 |