| NPI | 1992795918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA07265800) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA07265800) |
| 208600000X Surgery (Licence: NY 165052) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2021-02-17 |