| NPI | 1245296664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 59058) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.149494) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA MD-44558) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-08-20 |