| NPI | 1710904651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G83840) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G83840) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2025-02-10 |