| NPI | 1285787341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.134693) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD T4123) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2022-02-25 |