| NPI | 1215446364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 340050) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 57.245165) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 279734) | |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2026-05-13 |