| NPI | 1568515393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME161975) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX N7475) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-01-25 |