| NPI | 1891954947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA08728500) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 240912) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2015-04-23 |