| NPI | 1316450869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 86305) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D83934) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 51750) | |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2020-12-08 |