| NPI | 1770547572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WA MD60321869) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME84288) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60321869) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-04-24 |