| NPI | 1952564056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TX Q0378) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036120919) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2014-08-08 |