| NPI | 1316360811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35136314) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: DC MD200001308) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 326238) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2023-11-02 |