| NPI | 1104448265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX V9690) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A153728) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-11-03 |