| NPI | 1194828251 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301069411) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301069411) | 
| Enumeration Date | 2006-09-06 | 
| Last Update Date | 2023-08-08 |