| NPI | 1770713943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME124155) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP1-0034820) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 075870) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2022-05-02 |