| NPI | 1770803199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 67158) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 247474) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2015-04-16 |