| NPI | 1699911644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD437266) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 004012-1) |
| 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: PA MT192045) | |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2018-03-17 |