| NPI | 1912149865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 267342) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 267342) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2023-07-07 |