| NPI | 1154563906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2013-01958) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-01958) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2024-01-24 |