| NPI | 1114122405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CT 076337) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101256181) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019584) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-01-19 |