| NPI | 1609230176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD496670) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101271002) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2026-08-04 |