| NPI | 1720309917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NE 32768) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-057394) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD460780) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-02-09 |