| NPI | 1659392256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME110661) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME110661) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A52781) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-07-21 |