| NPI | 1710162193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA09854200) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 245236) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2024-03-11 |