| NPI | 1174592414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO CDR.0004679)  | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 34725-20)  | 
| Enumeration Date | 2006-03-17 | 
| Last Update Date | 2025-01-31 |