| NPI | 1386979144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX Q5090) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 245584) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2022-04-11 |