| NPI | 1699117101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35c.000928) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S7671) |
| 208600000X Surgery (Licence: IL 036135491) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036135491) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35c.000928) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX S7671) | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2023-12-20 |