| NPI | 1467687962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: DC MD047628) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT195497) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195497) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2019-09-30 |