| NPI | 1598022386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME139037) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 58687) |
| 208600000X Surgery (Licence: MN 58687) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-09-13 |