| NPI | 1396902730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NY 249302) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IL 036-115750) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2013-01-17 |