| NPI | 1588956957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 323194) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 323194) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR E11964) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2022-06-21 |