| NPI | 1053667220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA MD-46280) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-46280) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10044691) | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2019-09-26 |