| NPI | 1629271200 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME153089) | 
| Additional Taxonomies | 208600000X Surgery (Licence: CA A85960) | 
| 208600000X Surgery (Licence: OK 30875) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OK 30875) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A85960) | |
| Enumeration Date | 2007-06-09 | 
| Last Update Date | 2022-04-13 |