| NPI | 1588959548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036133474) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OH 57.017278) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2021-02-22 |