| NPI | 1508127036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 77529) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 288322) |
| 208600000X Surgery (Licence: RI LP02613) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2025-12-31 |