| NPI | 1215123450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 61345) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 61345) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2022-01-31 |