| NPI | 1699851915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.125851) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301081437) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WI 57479) | |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2021-04-01 |