| NPI | 1275811200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: WI 76036) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: OH 35.129944) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 76036) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2024-02-27 |