| NPI | 1780679357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9800856) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 9800856) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 9800856) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-03-10 |