| NPI | 1639303670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D71041) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 227025) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 227025) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2011-09-08 |