| NPI | 1578519096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS-007731-L) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA OS-007731-L) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2025-05-16 |