| NPI | 1598993123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 252891-1) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 252891-1) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2014-05-01 |