| NPI | 1609025204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CO DR.0054839) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036114906) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 104331) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: AZ 45194) | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2020-06-03 |