| NPI | 1780911032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A124858) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: CA A124858) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2024-04-27 |