NPI | 1285086306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA OS019122) |
Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 323940-01) |
Enumeration Date | 2016-07-13 |
Last Update Date | 2023-07-27 |