| NPI | 1760655567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D95257) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 225044) |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2022-09-06 |