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 |