| NPI | 1194987115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2016-01592) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125054167) |
| 208600000X Surgery (Licence: NC 2016-01592) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036131792) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35126191) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2023-07-24 |