| NPI | 1275997611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2023011646) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD047511) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2023-07-10 |