| NPI | 1154300903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX N0286) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 21707) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2022-01-28 |