| NPI | 1518221704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: GA 86721) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: IL 036143834) |
| 2086S0129X Surgery Vascular Surgery (Licence: FL ME147110) | |
| 2086S0129X Surgery Vascular Surgery (Licence: IL 125.061434) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2020-11-12 |