| NPI | 1386613149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME155247) |
| Additional Taxonomies | 172A00000X Driver (Licence: VA 0101238653) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD431256) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-10-25 |