| NPI | 1245493733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35131402) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2008015647) |
| 208600000X Surgery (Licence: MO 2010017357) | |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2026-06-16 |