| NPI | 1326013509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: NJ 25MA04898900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA04898900) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA04898900) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-04-29 |