| NPI | 1205921988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD056136L) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD056136L) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD056136L) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-12-31 |