| NPI | 1902234024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 285493) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-256613) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2017-02-02 |