| NPI | 1518320092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 310738) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA11966500) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-02-12 |