| NPI | 1639517006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 76981) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 286799) |
| 208600000X Surgery (Licence: MA 256414) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036.148694) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 286799) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2022-08-25 |