| NPI | 1124400759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD H0094232) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT016341) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 303882) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2022-12-07 |