| NPI | 1134193840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 25201) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 28899) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-04-05 |