| NPI | 1285895292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2017-00587) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 136241) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-04-14 |