| 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 | 2022-04-08 |