| NPI | 1215101787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 57895) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD456405) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY FL056) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2023-04-03 |