| NPI | 1316178502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S5457) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN10628) |
| 208600000X Surgery (Licence: FL TRN14433) | |
| 208600000X Surgery (Licence: OH Credential 57.01570) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME130909) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2020-04-15 |