| NPI | 1225443393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WI 103674-875) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036173270) |
| 2086S0129X (Licence: PA MT206680) | |
| 2086S0129X (Licence: FL ME150750) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2026-06-17 |