| NPI | 1609142074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036142476) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036142476) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2023-08-31 |