| NPI | 1326110081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA09252000) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MA 219576) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AL MD28398) | |
| 2086S0129X (Licence: PA MD442847) | |
| Enumeration Date | 2006-11-15 | 
| Last Update Date | 2013-03-14 |