| NPI | 1134160435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NJ 25MA09413600) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: CT 038845) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-06-16 |