| NPI | 1023300647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO 68526) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN15980) |
| 2086S0129X Surgery, Vascular Surgery (Licence: CO 68526) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: OH 57) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2024-07-25 |