| NPI | 1306080619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 283583-1) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.135322) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2016-10-24 |