| NPI | 1821256710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA A119951) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036.125582) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2021-11-18 |