| NPI | 1326303025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL TRN22304) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A209545) |
| 208600000X Surgery (Licence: CA A209545) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2026-08-03 |