| NPI | 1225015324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 10249) |
| Additional Taxonomies | 202K00000X (Licence: PA MD019142E) |
| 202K00000X (Licence: VA 0101256377) | |
| 208600000X Surgery (Licence: VA 0101256377) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AL 10249) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2022-01-21 |