| NPI | 1184644700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ MA08520700) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD067325L) |
| 2086S0129X Surgery, Vascular Surgery (Licence: PA MD067325L) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD067325L) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD067325L) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2014-08-20 |