| NPI | 1760626436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD417803) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NM MD2017-0836) |
| 208600000X Surgery (Licence: NM MD2017-0836) | |
| 208600000X Surgery (Licence: NY 254620-1) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NM MD2017-0836) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 254620) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD417803) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 254620) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD417803) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 003115) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD417803) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2020-10-15 |