| NPI | 1700014289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036140186) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.140186) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-05-04 |