| NPI | 1306108899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2018-01654) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01654) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 183771) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-10-26 |