| NPI | 1215128194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NH LT-3600) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.133696) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2023-11-17 |