| NPI | 1275623175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101242312) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC LL27201) |
| 208600000X Surgery (Licence: PA MD-066612-L) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD-066612-L) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2026-01-23 |