| NPI | 1114245032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NM MD2018-0635) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197425) |
| 208600000X Surgery (Licence: PA MT197425) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2023-07-13 |