| NPI | 1962791285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 279308) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 036143994) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2020-12-21 |