| NPI | 1720185101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 11159) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: WV 11159) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-04-13 |