| NPI | 1407820285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 116612) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NY 116612) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2008-02-08 |