| NPI | 1164455432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00041836) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD433604) |
| 208600000X Surgery (Licence: PA MD433604) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2026-01-20 |