| NPI | 1760937189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.149354) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 27885) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2024-02-19 |