| NPI | 1245423367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX R3359) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD429641) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 245829) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-01-04 |