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 |