| NPI | 1730354945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX P3074) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 93623) |
| 208600000X Surgery (Licence: OH 35089747) | |
| 208600000X Surgery (Licence: TX P3074) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 48259) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2023-09-27 |