| NPI | 1619043890 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 9875) | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 9875) | 
| 2086S0129X (Licence: AZ AZ 9875) | |
| Enumeration Date | 2006-11-28 | 
| Last Update Date | 2025-08-28 |