| NPI | 1881625564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0069418) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA07028800) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-09-08 |