| NPI | 1225423510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101276817) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101276817) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-08-04 |