NPI | 1689100349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 79399) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT212903) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2025-05-19 |