| NPI | 1811154537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD60000910) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036115652) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2021-05-04 |