| NPI | 1629311451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 85683) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125062882) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN26717) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2020-08-11 |