| NPI | 1346690302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV 24044) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.072224) |
| 2086S0129X Surgery Vascular Surgery (Licence: PA MT211309) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-05-02 |