NPI | 1851804777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY NA) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MD 24985) |
Enumeration Date | 2017-11-14 |
Last Update Date | 2024-04-15 |