| NPI | 1801853031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 34591) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 34591) |
| 2086S0129X Surgery, Vascular Surgery (Licence: NJ 34591) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2017-03-30 |