| NPI | 1083881023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD447960) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA08991700) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2013-04-18 |