| NPI | 1811216419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA10361400) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MT197212) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2018-08-03 |