| NPI | 1538199971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 19871) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 19871) |
| 208600000X Surgery (Licence: AZ 19871) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-01-17 |