| NPI | 1336520501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX U8529) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U8529) |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2024-12-16 |