| NPI | 1003887407 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 27378)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09524500)  | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA09524500)  | |
| Enumeration Date | 2006-02-01 | 
| Last Update Date | 2023-02-10 |