| NPI | 1720167372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX L7556) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L7556) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00031714) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2023-03-07 |