| NPI | 1629418975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA10848600) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IL 146648) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2020-08-12 |