| NPI | 1750529111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.124543) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 242774-1) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2021-01-08 |