| NPI | 1124468517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2022037472) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-9839) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA DO-05518) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2023-03-07 |