| NPI | 1366825812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX V0862) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 69012) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2024-07-02 |