| NPI | 1053601195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 5101021356) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.051876) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2022-04-14 |