| NPI | 1760497390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101258749) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D45046) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2021-07-26 |