| NPI | 1619134475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: UT 12841173-1204) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MB08940000) |
| 2086S0129X Surgery, Vascular Surgery (Licence: ND LT18891) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MB08940000) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2023-01-19 |