| NPI | 1588845028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL 165577) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 47832) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0074606) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD458611) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2024-02-28 |