| NPI | 1730574278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WI 87358-20) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA12861100) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 87358-20) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 310646) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2026-08-07 |