| NPI | 1588051494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60573981) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60573981) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MT MED-PHYS-LIC-100589) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-02-19 |