| NPI | 1013116946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 51210) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 22857) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2023-11-27 |