| NPI | 1689017246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101289280) |
| Additional Taxonomies | 2086S0129X (Licence: VA 0101289280) |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2026-08-26 |