| NPI | 1770796641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME114052) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: FL ME114052) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-04-14 |