| NPI | 1285753111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D75937) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301081441) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301081441) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-10-17 |