| NPI | 1528096625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ MA08489400) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD039657E) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-09-12 |