| NPI | 1053727719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 12779409-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 260348) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2022-03-30 |