| NPI | 1689763393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101285455) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2015-02472) |
| 208000000X Pediatrics (Licence: NC 2015-02472) | |
| 208600000X Surgery (Licence: NC 2015-02472) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2015-02472) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0104688) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2026-07-15 |