| NPI | 1619389939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 336122738) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2024026870) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2024-10-22 |