| NPI | 1184035610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101287281) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101287281) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2025-11-05 |