| NPI | 1023366820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 77550-20) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101281023) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2024-08-15 |