| NPI | 1154477784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 77146) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1347) |
| 208600000X Surgery (Licence: MD D0081622) | |
| 208600000X Surgery (Licence: TX S4852) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S4852) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2026-05-29 |