| NPI | 1548792070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2025-01352) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2025-01352) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2025-10-01 |