| NPI | 1760655567 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO CDR.0004725)  | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D95257)  | 
| 208600000X Surgery (Licence: MA 225044)  | |
| Enumeration Date | 2008-04-12 | 
| Last Update Date | 2025-09-10 |