| NPI | 1629008628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.061926) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35061926V) |
| 208600000X Surgery (Licence: KY 29644) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 29644) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35061926V) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-07-14 |