| NPI | 1346691458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TN 72657) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2022-01381) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX 46408) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2025-01-11 |