| 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 |