| NPI | 1386626992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AL 20234) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 13194R) |
| 2086S0129X Surgery, Vascular Surgery (Licence: AL 20234) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2023-06-29 |