| NPI | 1265812812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 305600) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125066701) |
| 208600000X Surgery (Licence: NY 305600) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-12-30 |