| NPI | 1508196122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036117153) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036117153) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2021-04-07 |