NPI | 1043666985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA12797700) |
Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036.164984) |
Enumeration Date | 2016-05-10 |
Last Update Date | 2025-08-07 |