| NPI | 1598053092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S2205) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD462544) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2019-10-24 |