| NPI | 1710511209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX 46981) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: TX 46981) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-03-03 |