| NPI | 1215073853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: CA A140713) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A140713) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A140713) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-07-07 |