| NPI | 1003872474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA07250800) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD427177) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2019-04-02 |