| NPI | 1104906452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX G8840) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX G8840) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-12-22 |