NPI | 1114086527 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ MA43494) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ MA43494) |
Enumeration Date | 2006-12-08 |
Last Update Date | 2012-11-14 |