| NPI | 1043715501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.149681) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN26700) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-09-30 |