| NPI | 1558664599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25ma10140900) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA10140900) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2024-04-24 |