| NPI | 1710979653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 3461201205) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: UT 346120-1206) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-01-26 |