| NPI | 1033215017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 14714) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 14714) |
| 2086S0129X Surgery, Vascular Surgery (Licence: KY 14714) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-12-04 |