| NPI | 1316992365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME97766) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME97766) |
| 2086S0129X (Licence: AL 25242) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-07-19 |