| NPI | 1598812703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A106625) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A106625) |
| 208600000X Surgery (Licence: CA A106625) | |
| 208600000X Surgery (Licence: WY 7817A) | |
| 208600000X Surgery (Licence: MT MED-PHYS-LIC-103010) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A106625) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2024-04-15 |