| NPI | 1669497624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 55360) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00035753) |
| 208600000X Surgery (Licence: MN 107785) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-03-14 |