| NPI | 1629206032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA08690700) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 046756) |
| 2086S0129X Surgery, Vascular Surgery (Licence: SC 88728) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2023-07-21 |