| NPI | 1144247131 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA05106400) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD027254E) | 
| Enumeration Date | 2006-07-16 | 
| Last Update Date | 2015-06-22 |