NPI | 1932281219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NJ MA07158500) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ MA07158500) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2010-06-30 |