| NPI | 1407299761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX R0083) | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX R0083) | 
| Enumeration Date | 2013-04-16 | 
| Last Update Date | 2023-08-23 |