| NPI | 1255422267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 81459) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME155131) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301104138) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-07-01 |