| NPI | 1265496962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 288615) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA11739700) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CT 73713) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2025-01-28 |