| NPI | 1750434890 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NH 17151)  | 
| Additional Taxonomies | 2086S0129X  (Licence: MD D0055670)  | 
| 2086S0129X  (Licence: AZ 35549)  | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0055670)  | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 35549)  | |
| Enumeration Date | 2007-01-20 | 
| Last Update Date | 2021-09-22 |