| NPI | 1003858127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX N1301) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT 10503) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2026-08-11 |