| NPI | 1497954416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 5414427-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 5414427-1205) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-03-15 |