| NPI | 1467455048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 159622) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 159622) |
| 207L00000X Anesthesiology (Licence: NY 159622) | |
| 208600000X Surgery (Licence: NY 159622) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2010-11-29 |