| NPI | 1689800872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR E-17168) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: SC 84041) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2023-11-15 |