| NPI | 1093770604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA12158900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 300021) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 30021) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 430276) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-04-25 |