| NPI | 1619179686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA09720400) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD439578) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-09-02 |