| NPI | 1043654312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MS 30035) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL MD.33569) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2022-07-05 |