| NPI | 1255863593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AL MD.37760) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN34386) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-07-31 |