| NPI | 1225087380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0102204860) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2012018846) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MO 2012018846) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2022-07-21 |