| NPI | 1609071828 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX R5976) | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX R5976) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2015-01745) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: NC 2015-01745) | |
| Enumeration Date | 2007-06-18 | 
| Last Update Date | 2025-08-13 |