| 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 |