| NPI | 1881814762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: IL 036-155542) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200400160) |
| 2086S0129X Surgery Vascular Surgery (Licence: VA 0101258912) | |
| 2086S0129X Surgery Vascular Surgery (Licence: MA 240837) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2021-03-22 |