| NPI | 1063568665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX V5021) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 212623) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME103129) | |
| Enumeration Date | 2007-01-26 | 
| Last Update Date | 2025-01-13 |