| NPI | 1528301603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KS 04-46979) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD475125) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-03-11 |