| NPI | 1700142858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A160343) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 281975) |
| 208600000X Surgery (Licence: CA A160343) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2024-04-27 |