| NPI | 1578190179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036.173516) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: NY TBD) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-05-11 |