| NPI | 1407825433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MB083768000) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA OS010515L) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-03-07 |