| NPI | 1487843223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME174114) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO DR.0058997) |
| 208600000X Surgery (Licence: OH 57012974) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2025-05-15 |