| NPI | 1699825158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 12203) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: WV 12203) |
| 2086S0129X Surgery Vascular Surgery (Licence: OH 35042462) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35042462) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-04-21 |