| NPI | 1265627384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD449843) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 242925) |
| 208600000X Surgery (Licence: PA MT196091) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2014-01272) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2015-10-30 |