| NPI | 1730163643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME142684) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: NC 2016-00697) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2024-01-29 |