| NPI | 1437543816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME157249) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME157249) |
| 2086S0129X Surgery, Vascular Surgery (Licence: IL 036152708) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2022-06-17 |