| NPI | 1720256332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KY 21240) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301034086) |
| 208600000X Surgery (Licence: MI 4301034086) | |
| Enumeration Date | 2008-02-16 |
| Last Update Date | 2022-01-04 |