| NPI | 1457617144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME148707) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.136420) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.136420) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2021-04-05 |