| NPI | 1538518667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA11944200) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 308239) |
| 208600000X Surgery (Licence: RI LP03771) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2023-09-22 |