| NPI | 1720084122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 225983) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 225983) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 225983) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2021-02-17 |