| NPI | 1801881487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA03498600) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA03498600) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2009-04-09 |