| NPI | 1164591772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: VA 0101044374) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101044374) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2026-09-19 |