| NPI | 1174938310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2021013046) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 298826) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-04-26 |