| NPI | 1740505056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 268455) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 268455) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2024-02-12 |