| NPI | 1376063180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 71776) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 71776) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT213104) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2023-10-17 |