| NPI | 1053676809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 259578-1) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 259578) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NH LT3350) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD475942) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-11-09 |