| NPI | 1578857470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S7136) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S7136) |
| 208600000X Surgery (Licence: OK 28598) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX S7136) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2020-09-16 |