| NPI | 1720368657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: IL 036139697) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A157256) |
| 2086S0129X Surgery Vascular Surgery (Licence: CA A157256) | |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2021-04-27 |