| NPI | 1811230626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA12322600) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 298612) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2024-08-01 |