| NPI | 1750431094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35042925) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 11190) |
| 208600000X Surgery (Licence: OH 35042925) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: WV 11190) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 35042925) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 11190) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-04-21 |