| NPI | 1124475355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A171789) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10055821) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2024-06-05 |