Want to know the difference between a CTO and a VP Engineering?

It's more of a personality trait that a "role". A typical CTO in a small organization is less of a people person and more of a technologist, the VPE is more of a business process person (it needs to ship on tuesday, don't forget the customer). As organizations upside into big entities that role separation still exists, where the VPE is very much management (performance reviews, schedules, budgets) and the CTO is now more front facing but still more focused on the technologies/industry than the process.

It seems to me that a good CTO can cross disciplines and understand technology really well, but also understand the user of the product really well regardless of the domain.

For example, if I make medical software, I should understand all of the technology I can use to build the software, but I should really have a solid understanding of how doctors operate and how my software can do something for them at a practical level. The CTO also acts as an interface between wildly different parts of an organization. Again on this example, I may have a doctor on staff who tests our software and helps set requirements, but is not part of engineering. The CTO should be able to capture those needs and build them into the final product vision the VPE will then set about building.

A VPE on the other hand should understand technology really well, but also understand all of the management considerations necessary to actually "build" the thing. They may not know about being a doctor, but they can build a smart work schedule that will make sure I get my product out the door on time and within budget.

The third role he had there, PM, should know how to administer the plan the VPE setup and keep all the ducks in a row. In a large organization, several PMs will report status of various projects to the VPE and make sure that the plan set forth by the VPE is operating.

In my experience in a startup people have no labels/titles associated to them. They are the directors and they have to take out the trash too. Tthe author claims he has much experience in the "startup organization domain" but he misses the point of hard, smart work on turning an idea into business regardless of the labels each member has.