| NPI | 1457627226 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 333231) | 
| Additional Taxonomies | 208600000X Surgery (Licence: LA 333231) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-27 | 
| Last Update Date | 2022-11-21 |