| NPI | 1780948620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME161390) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2019-02185) |
| 2086S0129X (Licence: NC 2019-02185) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2019-02185) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2025-08-16 |