| NPI | 1992083521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA10613400) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R72587) |
| 208600000X Surgery (Licence: NJ 25MA10613400) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-05-02 |