| NPI | 1215391628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 103985) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 14413) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2025-04-07 |