| NPI | 1710025580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 75-000001) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 75.000001) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 75.000001) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-05-21 |