| NPI | 1336340041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX Q7879) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 21619) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-03-31 |