| NPI | 1639154347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 103127) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD439333) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL PA9119801) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-08-15 |