| NPI | 1639210743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 55522) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G30889) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G30889) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2021-06-16 |