| NPI | 1760587430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA10002400) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD441658) |
| 2086S0129X Surgery, Vascular Surgery (Licence: RI MD15079) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: NY 236613) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-06-14 |