| NPI | 1760820682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CT 68087) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D85283) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2021-06-21 |