| NPI | 1619972684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NC 33994) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 33994) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 33994) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2021-07-21 |