| NPI | 1154608255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 70937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 70937) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.143209) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.020334) | |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2022-08-10 |