| NPI | 1376572867 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX K5159) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K5159) | 
| 2086S0129X (Licence: TX K5159) | |
| Enumeration Date | 2006-06-30 | 
| Last Update Date | 2023-12-20 |