| NPI | 1689625162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: GA 53641) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 053461) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 53641) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-05-26 |