| NPI | 1225615669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX W6587) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 326290) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-06-02 |