| NPI | 1528089018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD032074E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD032074E) |
| 208600000X Surgery (Licence: NJ 25MA06544900) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA06544900) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-03-17 |