| NPI | 1770799660 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 41460)  | 
| Additional Taxonomies | 2086S0129X  (Licence: AZ 41460)  | 
| Enumeration Date | 2007-05-15 | 
| Last Update Date | 2025-10-29 |