| NPI | 1720294069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08505400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MB08505400) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MB08505400) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-06-02 |