| NPI | 1356301691 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC 19281)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: NC 31391)  | 
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2025-08-16 |