| NPI | 1215107982 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301085693) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085693) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 45870) | |
| Enumeration Date | 2008-03-09 | 
| Last Update Date | 2023-12-14 |