NPI | 1881088284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA11579700) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD478803) |
Enumeration Date | 2015-03-24 |
Last Update Date | 2023-11-16 |