| NPI | 1023472503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME161935) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 1934836) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101286845) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-12-02 |