| NPI | 1386025062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA A149019) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IL 036.157259) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2023-12-05 |