| NPI | 1003398207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY FL060) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KY FL060) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2021-12-07 |